Highlighting the burden of malarial infection and disease in the neonatal period: making sense of different concepts
- PDF / 800,804 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 101 Downloads / 140 Views
(2020) 19:311 Nhama et al. Malar J https://doi.org/10.1186/s12936-020-03394-3
Open Access
COMMENTARY
Highlighting the burden of malarial infection and disease in the neonatal period: making sense of different concepts Abel Nhama1,2, Rosauro Varo1,3 and Quique Bassat1,3,4,5,6,7*
Background In malaria-endemic areas, the first year of life is indisputably considered one of the most vulnerable periods for malaria disease, and malaria-associated mortality in this age group is typically high, usually as a consequence of severe anaemia, among other possible complications [1]. However, malaria disease during the first 4 weeks of life (which includes both congenital and neonatal malaria) is comparatively much less common than among older infants. Congenital and neonatal malaria show important differences in terms of acquisition route and timing of the infection. They both are also importantly influenced by background malaria endemicity and degrees of population-acquired immunity. Acquisition route Malaria in the first weeks of life can essentially arise from two very distinct transmission mechanisms. It can either be vertically transmitted from an infected pregnant mother to the child (in utero or during delivery) [2], or it can be acquired through a mosquito bite transmitting the infective forms of the parasite (sporozoite). In the first case, it is often challenging to determine whether the infection is derived from parasites acquired before delivery or as a result of contamination by maternal blood at birth. In the second case, and given the necessary incubation period of the parasite (~ 10–14 days, species *Correspondence: [email protected] 7 Barcelona Institute for Global Health, Carrer Roselló 132, Barcelona, Sobreátic 08036, Spain Full list of author information is available at the end of the article
dependant), it would be difficult to conceive any newborn becoming sick during its first week of life through this transmission route. By convention, therefore, it has been agreed to use different nomenclature to differentiate the assumed transmission route. Malaria cases detected in the first 7 days of life are called congenital malaria, whereas those detected henceforth and until 28 days of life are termed neonatal malaria. Such a distinction between congenital and neonatal malaria is relevant in endemic areas, because prevention methods designed to avoid infection in the baby should differentially target the pregnant mother or the baby. Outside of malaria endemic areas, malaria in the newborn is always assumed to have been transmitted congenitally, irrespective of the time of onset of symptoms. The importance of the background immunity status of the population against malaria
One of the fundamental factors in the current understanding of the pathophysiology and clinical presentation of malaria is related to the presence (or not) of any degree of acquired immunity to malaria from the human host [3]. Indeed, in malaria-endemic areas, repeated exposure to infectious mosquito bites leads to the progress
Data Loading...
